| NPI | 1780846501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY HAGFORS CEO 541-706-5401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2012-01-31 |